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The ProviderTrust Blog

Your source for healthcare compliance news, advice from industry experts, and all things related to OIG exclusions.

Long Term Care, Complianc Plan, SNF, SNF Requirements

Part 2: SNF Requirements of Participation - One Bite At a Time

Posted by Donna Thiel on Thu, Mar 09, 2017

Overwhelmed? Don’t know where to start? Don’t worry, just follow the old adage, “How do you eat an elephant? One bite at a time”. Treat the new Requirements as your elephant and break up the Requirements into small bite size pieces.

If you are feeling overwhelmed, I completely understand, but the good news is that the implementation of these Requirements is in three phases. The first of course went into effect November 28, 2016, but Phase II and III you have a little more time. Phase II goes into effect on November 28, 2017 but Phase III not until November 28, 2019.

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Long Term Care, SNF

SNF Requirements of Participation

Posted by Donna Thiel on Tue, Mar 07, 2017

New Requirement in § 483.12 Freedom from abuse, neglect, and exploitation.

Did you read the new Skilled Nursing Facility Requirements of Participation (ROP) section 483.12 carefully?  In a document of nearly 200pages and three columns of small print, sometimes it is easy to miss an important change.  I read the new ROP multiple times and until just a few weeks ago I missed an important new requirement in the Freedom from abuse, neglect and exploitation section.  Hopefully, you aren’t like me and you saw this already but just in case I thought I would highlight the change for you and give you some great news about meeting this new requirement.

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OIG Exclusion List, Healthcare Compliance, OIG, Healthcare Technology, Vendor Compliance, Data Management

Vendor Compliance Goes Beyond Employee Monitoring (Beyond Employee Monitoring eBook)

Posted by Michael Rosen, ESQ on Thu, Mar 02, 2017

Our latest eBook, Beyond Employee Monitoring: Vendors, Contractors and Third Parties, dives into the complexities of vendor monitoring. From digesting new regulations to discussing best practices, we hope this book helps you tackle your job with confidence. 

Download our free Beyond Employee Monitoring eBook here to kick start your vendor monitoring process.

Our eBook journey began with the release of The Ultimate Guide to Exclusion Monitoring. It covers everything you need to know about Office of Inspector General (OIG) exclusion monitoring and the OIG's regulations surrounding monthly monitoring and exclusion databases. We received an overwhelming amount of positive feedback for our exclusions eBook, so we decided to tackle the ins and outs of vendor monitoring as well. This 40+ page read covers the details and risks of not complying with OIG regulations as it pertains to vendor monitoring.

We're happy to announce an addition to our eBook collection! Our newest eBook, Beyond Employee Monitoring: Vendors, Contractors and Third Parties,  dives into the complexities of vendor monitoring. From digesting new regulations to discussing best practices, we hope this book helps you tackle your job with confidence. 

Download our free Beyond Employee Monitoring eBook here to kick start your vendor monitoring process.

Our eBook journey began with the release of The Ultimate Guide to Exclusion Monitoring. It covers everything you need to know about Office of Inspector General (OIG) exclusion monitoring and  regulations surrounding monthly monitoring and exclusion databases. We received an overwhelming amount of positive feedback for our exclusions eBook, so we decided to tackle the ins and outs of vendor monitoring as well. This 40+ page eBook covers the details and risks of not complying with OIG guidance and State and Federal regulations as it pertains to vendor monitoring.

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Healthcare Compliance, Fraud and Abuse

Healthcare Business Owner is Just as Liable for Fraud

Posted by Michael Rosen, ESQ on Thu, Feb 23, 2017

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OIG, mfcu

State Medicaid Fraud Control Units: You have 30 Days

Posted by Michael Rosen, ESQ on Tue, Feb 21, 2017

State Medicaid Fraud Control Units (MFCU) are responsible for investigating Medicaid fraud. This is part of the responsibility assigned to them from CMS as a part of receiving federal health care dollars to reimburse those services and items covered by Medicaid.

According to the OIG site, "Medicaid Fraud Control Units (MFCUs) investigate and prosecute Medicaid provider fraud as well as patient abuse or neglect in healthcare facilities and board and care facilities. MFCUs operate in 49 states and the District of Columbia. The MFCUs, usually a part of the State Attorney General's office, employ teams of investigators, attorneys, and auditors; are constituted as single, identifiable entities; and must be separate and distinct from the State Medicaid agency. OIG, in exercising oversight for the MFCUs, annually re-certifies each MFCU, assesses each MFCU's performance and compliance with Federal requirements, and administers a Federal grant award to fund a portion of each MFCU's operational costs."Performance Standard 8(f) states that a Unit should transmit to the federal OIG reports of all convictions for the purpose of exclusion from Federal health care programs, within 30 days of sentencing.

On June 1, 2012, the Federal Register published an important mandate to measure the success of state Medicaid Fraud Control Units. 

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